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Maternal Tobacco Use During Pregnancy and Child Neurocognitive Development
Troy B Puga1,2, Hongying Daisy Dai1, Yingying Wang3
1College of Public Health, University of Nebraska Medical Center, Omaha.
Insights
Maternal tobacco use during pregnancy (MTDP) is linked to lasting neurocognitive deficits in children. This study found lower cognitive scores and smaller brain regions in children exposed to MTDP.
Area of Science:
- Neuroscience
- Developmental Psychology
- Public Health
Background:
- Maternal tobacco use during pregnancy (MTDP) is a global concern.
- Longitudinal data on MTDP's impact on childhood neurocognition is limited.
- Understanding these effects is crucial for early intervention and prevention strategies.
Purpose of the Study:
- To investigate the association between maternal tobacco use during pregnancy (MTDP) and neurocognitive development in children aged 9 to 12 years.
- To identify specific cognitive functions and brain structures affected by prenatal smoke exposure.
- To provide longitudinal evidence on the enduring effects of MTDP.
Main Methods:
- A cohort study design was employed using data from the Adolescent Brain Cognitive Development (ABCD) Study.
- Children aged 9-10 years at baseline (Wave 1) were followed for 2 years.
- Neurocognition was assessed using the NIH Toolbox Cognition Battery, and brain structure was analyzed using structural magnetic resonance imaging (sMRI).
Main Results:
- Children with maternal tobacco use during pregnancy (MTDP) showed significantly lower scores in oral reading recognition, picture sequence memory, and picture vocabulary.
- These cognitive deficits persisted at the 2-year follow-up.
- Structural MRI revealed smaller cortical areas and volumes in specific brain regions, including the precentral, inferior parietal, and entorhinal areas, in children with MTDP.
Conclusions:
- Maternal tobacco use during pregnancy (MTDP) is associated with enduring neurocognitive deficits in children.
- Prenatal smoke exposure impacts both cognitive performance and brain structure.
- Further research is recommended to explore the links between MTDP, cognitive skills, and memory.
Importance:
Maternal tobacco use during pregnancy (MTDP) persists across the globe. Longitudinal assessment of the association of MTDP with neurocognitive development of offspring at late childhood is limited.
Objectives:
To examine whether MTDP is associated with child neurocognitive development at ages 9 to 12 years.
Design, Setting, And Participants:
This cohort study included children aged 9 and 10 years at wave 1 (October 2016 to October 2018) and aged 11 to 12 years at a 2-year follow-up (wave 2, August 2018 to January 2021) across 21 US sites in the Adolescent Brain Cognitive Development (ABCD) Study. Data were analyzed from June 2022 to December 2023.
Exposure:
MTDP.
Main Outcomes And Measures:
Outcomes of interest were neurocognition, measured by the National Institutes of Health (NIH) Toolbox Cognition Battery, and morphometric brain measures through the region of interest (ROI) analysis from structural magnetic resonance imaging (sMRI).
Results:
Among 11 448 children at wave 1 (mean [SD] age, 9.9 [0.6] years; 5990 [52.3%] male), 1607 children were identified with MTDP. In the NIH Toolbox Cognition Battery, children with MTDP (vs no MTDP) exhibited lower scores on the oral reading recognition (mean [SE] B = -1.2 [0.2]; P < .001), picture sequence memory (mean [SE] B = -2.3 [0.6]; P < .001), and picture vocabulary (mean [SE] B = -1.2 [0.3]; P < .001) tests and the crystallized cognition composite score (mean [SE] B = -1.3 [0.3]; P < .001) at wave 1. These differential patterns persisted at wave 2. In sMRI, children with MTDP (vs no MTDP) had smaller cortical areas in precentral (mean [SE] B = -104.2 [30.4] mm2; P = .001), inferior parietal (mean [SE] B = -153.9 [43.4] mm2; P < .001), and entorhinal (mean [SE] B = -25.1 [5.8] mm2; P < .001) regions and lower cortical volumes in precentral (mean [SE] B = -474.4 [98.2] mm3; P < .001), inferior parietal (mean [SE] B = -523.7 [136.7] mm3; P < .001), entorhinal (mean [SE] B = -94.1 [24.5] mm3; P < .001), and parahippocampal (mean [SE] B = -82.6 [18.7] mm3; P < .001) regions at wave 1. Distinct cortical volume patterns continued to be significant at wave 2. Frontal, parietal, and temporal lobes exhibited differential ROI, while there were no notable distinctions in the occipital lobe and insula cortex.
Conclusions And Relevance:
In this cohort study, MTDP was associated with enduring deficits in childhood neurocognition. Continued research on the association of MTDP with cognitive performance and brain structure related to language processing skills and episodic memory is needed.
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